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Picture sourced from:  Biswas A, et al. Human placenta/umbilical cord derivatives in regenerative medicine - Prospects and challenges. Biomater Sci. 2023 Jul 12;11(14):4789-4821. 

This blog is just a little bit, “Things that make you go, Hmm.”  A client just had her dog’s elbows injected with PRP and the veterinarian had told her about other options, on down the road if need be, as potential treatments for osteoarthritis.  One such therapy is placental extract injection.  In fact, the vet was having this done on her own horse.  So, I decided to do a bit of a dive into the research to see what this was about.  

First off, what are we talking about?  

Placenta-derived injectable products include, but are not limited to mesenchymal stem cells (MSCs).  

Is placental extract therapy the same as stem cell therapy?

No, placental extract therapy is not the same as stem cell therapy, although both can be derived from the placenta.

Placental Extract Therapy: 

• This involves using extracts from the placenta.  Such extracts are obtained by lysing human placental tissues collected at full-term delivery.  The extracts contain various components like proteins, minerals, amino acids, growth factors, cytokines, hormones, and other bioactive molecules but typically not live cells. These extracts are processed to provide therapeutic benefits potentially due to their biochemical properties. 
• Placental extracts have been used for their regenerative, anti-inflammatory, analgesic, antioxidant, anti-allergic, cyto-protective, and immune-modulatory effects. They are often used in dermatology, ophthalmology, and more recently, studied for conditions like osteoarthritis.

Stem Cell Therapy:

• Stem cell therapy, particularly when discussing placental stem cells, involves the use of live cells that have the potential to differentiate into various cell types. These cells can be mesenchymal stem cells (MSCs) derived from the placenta which are known for their regenerative capabilities.
• Stem cell therapy aims to replace or repair damaged tissue with new cells. These cells can promote healing through direct cellular replacement, immune modulation, or by secreting factors that encourage tissue regeneration.

KEY DIFFERENCES:

1.  Cellular Component: Stem cell therapy uses live cells with the capacity to divide and differentiate, whereas placental extract therapy usually does not include live cells.

2.  Purpose and Mechanism:

• Stem cells can integrate into tissues, differentiate into needed cell types, or secrete factors that promote regeneration or modulate the immune system.
• Placental extracts work through the biochemical properties of the components they contain, often stimulating the body's own repair processes without cell integration.

3.  Regulation and Application:

• Stem cell therapies are often more heavily regulated due to the use of live cells and the potential for cell division and integration into the patient's body.
• Placental extract treatments might be less regulated in some contexts, as they are often considered more akin to biologic drugs or supplements rather than cellular therapies.

Into the Literature

Flannery CR, et al. A novel placental tissue biologic, PTP-001, inhibits inflammatory and catabolic responses in vitro and prevents pain and cartilage degeneration in a rat model of osteoarthritis. Osteoarthritis Cartilage. 2021 Aug;29(8):1203-1212. 

A prepared formulation derived from human placental tissue were injected into rat knees with osteoarthritis (in vivo).  One injection significantly reduced pain responses throughout 6 weeks post-dosing. The magnitude and duration of pain reduction following a single intraarticular treatment with the product was comparable to that observed for animals treated with a corticosteroid (active control). For rats dosed twice with the placental extract tissue, significant reductions in cartilage histopathology scores were observed.

Kim JK, Kim TH, Park SW, Kim HY, Kim Sh, Lee Sy, Lee SM. Protective effects of human placenta extract on cartilage degradation in experimental osteoarthritis. Biol Pharm Bull. 2010;33(6):1004-10. 

Two studies were conducted using human placenta extract (HPE) products.  One on degenerative articular cartilage of rabbits (in vitro) and the other on induced-osteoarthritis knees in rats (in vivo).  HPE inhibited prostaglandin degradation in the in vitro study). In vivo, HPE reduced knee joint deformity and suppressed histological changes.  Over all its effects were cartilage protective.

Last thoughts

Without diving deeper, I think this sounds fascinating.  Naturally, ethical harvesting of an otherwise to be discarded full term placenta is imperative for this to be an accepted therapy. That piece in check, this sounds like a promising therapy, and I wonder if any of the vets that read this blog have had an opportunity to work with such products.  Let me know!

Additional References:

Pogozhykh O, Prokopyuk V, Figueiredo C, Pogozhykh D. Placenta and Placental Derivatives in Regenerative Therapies: Experimental Studies, History, and Prospects. Stem Cells Int. 2018 Jan 18;2018:4837930. 

Mohamed NS, Wilkie WA, Remily EA, Delanois RE. Can human placental extract help patients with osteoarthritis? Ann Transl Med. 2020 Feb;8(4):62.